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BC PharmaCare General Special Authority (HLTH 5328)

Use this one-page request only when a drug, device or supply has no specific BC PharmaCare Special Authority form. The prescriber marks it as a new request or renewal, names the medication with dose and regimen, and justifies it with the diagnosis, previously tried therapies and response, and any patient-specific contraindications to alternatives. PharmaCare may ask for more documentation.

Who completes it

The prescriber completes all three sections, giving a CPSBC or CRNBC licence number rather than an MSP billing number, and signs; there is no patient signature.

Submitting and payment

How to submit it
Submit it through Special Authority eForms, which PharmaCare says are simpler and quicker, or fax or mail the PDF to PharmaCare as printed in its header.

Good to know

  • PharmaCare's forms page labels this form 'use only if there is no specific form', so check the condition-based list of about 73 forms first.
  • Forms with missing information are returned for completion, and without a prescriber fax number or mailing address PharmaCare cannot send a response.
  • Approval only covers prescription costs; PharmaCare states it does not indicate whether the medication is suitable for the patient.
  • Coverage is not retroactive and starts when the approval is entered on the patient's PharmaNet record; faxed requests currently take about five weeks.

Get the official form

Download the current version from the source each time; forms change without notice.

PharmaCare Special Authority Request

Official pagePDF

Fill it with Vero

Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

See how Vero Documents works

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

When should I use the general BC Special Authority form?

Only when no drug-, device- or supply-specific Special Authority form exists. PharmaCare lists its specific forms by condition, and if none applies, prescribers can use HLTH 5328 or search the Special Authority drugs list for the benefit's criteria.

What should the justification on HLTH 5328 include?

Section 3 asks for the diagnosis requiring use, previously tried therapies and the patient's response, and any patient-specific contraindications to alternatives, with supporting details. The prescriber also gives the medication, dose and regimen, and marks the request as new or a renewal.

Which licence number goes on the BC Special Authority form?

The form asks for the prescriber's CPSBC or CRNBC licence number, not the MSP billing number. Patients are identified by Personal Health Number, which the form marks as critical for processing, while the prescriber's fax number is marked as critical for a timely response.